Emeka Arinze Ezeokeke

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34712 Issued in TX

Practice address

4819 Avenue Q
Lubbock, TX 79412-2209

Phone

(806) 686-6722

NPI assigned

Aug 25, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546473600000",
    "number": "1962879973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4819 AVENUE Q",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122209",
            "telephone_number": "806-686-6722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4819 AVENUE Q",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794122209",
            "telephone_number": "806-686-6722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1810 N 2nd St",
            "address_purpose": "LOCATION",
            "city": "Wausau",
            "state": "WI",
            "postal_code": "544033492",
            "country_code": "US",
            "telephone_number": "715-848-4884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EZEOKEKE",
        "first_name": "EMEKA",
        "middle_name": "ARINZE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-25",
        "last_updated": "2019-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "018001960",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Express Medical Supply LLC (AdaptHealth)
• Eyemart Express LLC
• Eyemart Express, LTD.
• Eyemasters of Texas LTD (EyeMasters)
• Jennifer Merle Ezell, FNP
• Jaden Heber Fackrell, MD
• Fadel Eye Group, LLC (Lubbock Eye Professionals)
• Tolulope Mary Fadipe, DDS
• Mandy M Fair, LMFT
• Jennifer-Marie C Fairchild, MA

• General Practice Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.